Ergonovine-testing-directed therapy and long-term outcome of sudden-death survivors with no apparent heart disease.
Coronary artery vasospasm, the most common cause of sudden death in patients with structurally normal hearts, is not well recognized. We describe 2 survivors of sudden death with ergonovine-inducible coronary artery vasospasm successfully treated long term with calcium channel blockers. Of the reported (17 worldwide) patients with documented vasospasm-mediated sudden cardiac death treated with calcium blockers, none have had a recurrent event. This is substantially less than the 6-month sudden-death rate of 18 % of untreated vasospasm. We advocate that ergonovine provocative testing of sudden-death survivors with structurally normal hearts, followed by appropriate therapy with calcium channel blockers, be the standard approach for these highly treatable patients.
Ritchie
M E
ME
Division of Cardiology,Veterans Administration Medical Center, University of Cincinnati College of Medicine, Ohio, USA.
Hattemer
C
C
Lenihan
D
D
D000328:Adult; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D004874:Ergonovine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017741:Survivors
D002121:Calcium Channel Blockers; D004874:Ergonovine